Rx for Readers: Attending to hygiene in geriatric homes

Readers get answers for their medical and health queries.

Geriatric home (illustrative) (photo credit: ING IMAGE/ASAP)
Geriatric home (illustrative)
(photo credit: ING IMAGE/ASAP)
I am 72 years old and live in an old-age home in Jerusalem. I have been suffering from a Shigella infection and am worried because hygienic conditions here are very poor. Residents are given medications from cups that are, maybe, wiped around the rim and not properly cleaned, for example. I worry about bacteria and viruses growing on surfaces like railings, tables and so on. How long do bacteria live on such surfaces? How can they be killed? E.W., Jerusalem
Associate Prof. Colin Block, head of the clinical microbiology unit in the department of clinical microbiology and infectious diseases at the Hadassah University Medical Center, Ein Kerem, Jerusalem, answers: Your questions raise a number of issues. Foremost among them is the need to fix the poor hygienic conditions at the geriatric home. This might require the intervention of the Health Ministry if no alternative is available. Action on this general level will reduce residents’ risk of infection by many kinds of viruses and bacteria.
These organisms can be present on the surfaces you mentioned, and there’s no good way of making sure they’re never there. General hygienic measures help to a limited degree. In the specific case of Shigella, very small numbers of bacteria can cause the disease and contamination of surfaces in bathrooms, including water faucets and door handles, is known to enable transmission of the bacteria. The source of these bacteria is most often a person with diarrhea due to Shigella.
As for how long dangerous bacteria remain potent on surfaces, survival of different bacteria on environmental surfaces is highly variable, and most of them won’t cause any significant harm.
Shigella, as it happens, is very sensitive to drying up and will die off quite quickly.
But even a small number of them can cause an infection.
On the other hand, Staphylococci and other skin bacteria can remain viable for a long time, but very seldom do they cause a health risk. All of us touch innumerable shared, non-sterile surfaces each day and don’t “catch” anything very frequently.
It’s complicated and I don’t want to launch into a long explanation of phenomena that need a fair amount of biological knowledge to understand. I also don’t think that intensive chemical treatment of frequently touched surfaces is likely to be adopted as a practical, or even a desirable, solution.
One of the best ways to prevent conditions like this, and indeed even viral respiratory infections, is for each person to attend to his or her own hand hygiene, after visiting the toilet and especially before eating, and also after contact with people who have colds. These days, in addition to washing with soap and water, one of the effective means for achieving this is to use alcohol-based gels or liquids for hand decontamination, which are meant to be used without water. These are easily available and in wide use in retirement homes, which are particularly sensitive places.
I am newly graduated from a teachers’ seminary and started teaching a fourthgrade class of boys last September. The class is quite unruly, even though I try to maintain discipline, but it’s hardest near the end of the day when they lose patience. Since then I have been suffering from laryngitis every few weeks. What can I do to keep my voice? R.N., Ness Ziona
Dr. Michal Icht, a clinical communication specialist and lecturer in the department for communication disorders at Ariel University, replies: Overuse of the voice is very common and can occur at all ages, from children as young as three or four to the elderly in their 80s. Most of the sufferers complain of having a rough or coarse voice, having to make too much effort to speak and even lack of a regular voice. It can be chronic or temporary. It can occur after the flu or another infection, and even cause pain in the throat. There may not be an observable cause.
There are early signs for voice disorders, such as light hoarseness, having a voice that “breaks,” sore throat, tiredness after continuous use of the voice (as in your case) and the need to clear the throat.
The more one is dependent professionally on one’s voice – such as a teacher, university lecturer, Knesset member, professional singer or market stall owner – the more annoying and worrisome voice disorders are, as they can affect one’s quality of life and making a living.
As a neophyte teacher, try to get advice from more experienced colleagues about maintaining discipline without raising your voice.
Speaking or singing ordinarily should not be a burden or cause discomfort, but when it does, and hoarseness or swallowing problems occur, you should consult an expert, including an ear-nose-and-throat specialist, who will probably refer you to a speech pathologist.
As for practical advice, if you suffer from hoarseness after teaching for hours, drink a lot of liquid such as water or elderberry tea to lubricate the mucous membranes in the throat. You can also inhale steam from a boiling pot for a few minutes at least once a day for this purpose. There are also things you should not do, such as drinking very hot or very cold drinks, beverages with a lot of caffeine, such as coffee, cola or regular teas, or alcohol.
If you have to speak for a long period, try to drink some water from time to time and take a few breaks if you can. When you feel a throat irritation coming on, it’s best to cough or drink a little. Avoid very spicy or very salty food before class, and of course, don’t smoke or be exposed to dust or chemicals that are liable to dry or irritate the throat membranes.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 9100002, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and place of residence.